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General NPI Number Information
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NPI Number | 1699119768
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Entity Type | Organization
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Legal Business Name | BO FENG D.D.S. INC.
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 18736 COLIMA RD
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-2916
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Country | US
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Telephone | 626-839-8389
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Fax |
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Provider Business Mailing Address
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Address Line | 1503 BANIDA AVE
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-2344
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | BO FENG
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Credential | DDS
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Telephone | 626-378-5690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 55448
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License Number State | CA
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